Heart failure has become a public health problem with increasing incidence and prevalence. Many patients first came to the primary care and managed by general practitioner. Accurate diagnosis is essential to provide good management of heart failure. However, symptoms and signs alone are often neither sufficient nor specific to confirm the diagnosis. Some studies show that heart failure patients are still incorrectly diagnosed and inadequately treated, despite the availability of current guidelines. Inadequacy of facilities is the main obstacle in diagnosing and managing heart failure, especially in developing countries like Indonesia. The medications recommended for treating heart failure are still under-prescribed. This review discuss about the challenges of diagnosis and management of heart failure in primary care.
e 29monitoring. Plasma AGT and angiotensin II level were performed at baseline and after 4 months of ARB therapy.
Results:Significantly reduced blood pressure in both daytime and 24 hours mean systolic/diastolic blood pressure were observed in patients with -217 AA/AG genotype who received telmisartan, but not valsartan, compared to those carrying GG genotype. The change of plasma AGT and angiotensin II level in those who had -217 AA/AG genotype showed no difference as compared to GG genotype after received telmisartan or valsartan.Conclusion: AGT G-217A polymorphism is associated with antihypertensive response to telmisartan, but not valsartan, in hypertensive patients.Introduction: Hypertension may affect any age, including young adults. Acute coronary syndrome (ACS) is one of the devastating complicationsof hypertension, and a common reason for hospitalization. Previous studies have found that having 2 or more risk factors increases the risk for multivessel disease.Objective: To review the role of hypertensionas a predictor for multivessel disease inhypertensive young adults with ACS at National Cardiovascular Centre Harapan Kita (NCCHK)
Methods:A retrospective study ofhypertensive young adults (18-40 years old)hospitalized due to ACS atNCCHK. The data were collected from medical records. The coronary angiography data from patients with at least 2 or more risk factors were analyzed.Results: From 194 hypertensive young adults hospitalized in NCCHK during 2011-2013, 100 patients (51.5%) were admitted with ACS. 61 patient underwent coronary angiography, and the result was 10 patients with normal coronary artery, 23 patients with single vessel disease, and 28 patients with multivessel disease. The odds of multivessel disease were 1.06 in patients with uncontrolled blood pressure (95% CI = 0.33-3.45), 0.91 in patients with diabetes (95% CI = 0.29-2.88), 1.04 in patients with family history of CAD (95% CI = 0.34-3.19), 0.9 in smokers(95% CI = 0.28-2.89), and 0.12 in patients with dyslipidemia(95% CI = 0.02-0.61).Conclusion: ACS was the most common reason for hospitalization of hypertensive young adults in NCCHK. Among the traditional risk factors, uncontrolled blood pressure has the highest odds in the development of multivessel disease.Background: Hypertension and hyperuricemia are factors related to cardiovascular disease risk. Hyperuricemia is found in approximately 25% patients with hypertension while hypertension is found in 30% patients with hyperuricemia or gout. The link between hypertension and hyperuricemia theoretically explained by the effect of uric acid on renal and vascular smooth muscle cells. Hyperuricemia leads to inflammation and endothelial dysfunction. Losartan is an angiotensin renin blocker that has other effects as an anti-inflammatory and uricosuric agent.Objective: This study to determine the effect of losartan on serum IL-6 levels in hypertensive patients with asymptomatic hyperuricemia in DR. Mohammad Hoesin Hospital Palembang.Result: Research subjects were 30 patients with 53.3% men and ...
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